CARE HOMES FOR OLDER PEOPLE
Ambleside Bank Care Home Older Persons Resource Centre High Street Lower Ince Wigan Greater Manchester WN3 4RL Lead Inspector
Judith Stanley Unannounced Inspection 8th March 2006 09:30 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information
Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address Ambleside Bank Care Home DS0000005720.V268739.R01.S.doc Version 5.1 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Ambleside Bank Care Home DS0000005720.V268739.R01.S.doc Version 5.1 Page 3 SERVICE INFORMATION
Name of service Ambleside Bank Care Home Address Older Persons Resource Centre High Street Lower Ince Wigan Greater Manchester WN3 4RL 01942 321112 01942 234331 ambleside_bank@hotmail.com Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Century Healthcare Limited Mrs Susan Jackson Care Home 30 Category(ies) of Dementia - over 65 years of age (1), Old age, registration, with number not falling within any other category (30) of places Ambleside Bank Care Home DS0000005720.V268739.R01.S.doc Version 5.1 Page 4 SERVICE INFORMATION
Conditions of registration: 1. 2. 3. The home is registered for a maximum of 30 service users to include:up to 30 service users in the category of OP (Older People) One named service user (RC) in the category of DE(E) (Dementia over 65 years of age) may be accommodated within the overall registered numbers The service should at all times employ a suitably qualified and experienced manager who is registered with the Commission for Social Care Inspection. 26th July 2005 Date of last inspection Brief Description of the Service: Ambleside Bank is a purpose built Older Peoples Resource Centre that provides personal care and support and rehabilitation care services for up to 30 individuals over the age of 65 years. The centre is approximately 10 minutes drive away from Wigan town centre; however some local amenities are close by. The centre offers five categories of placement; these include: 12 long term residential places, 8 intermediate beds, 6 respite beds, 4 emergency beds and up to 10 day care places. Admissions and discharges can occur on a daily basis. The centre provides 26 single rooms, and 2 shared rooms, all rooms have en suite facilities. There is a large patio area at the rear of the centre with appropriate seating for service users; car parking is available at the front of the centre. The external areas of the premises and grounds are well maintained. Ambleside Bank Care Home DS0000005720.V268739.R01.S.doc Version 5.1 Page 5 SUMMARY
This is an overview of what the inspector found during the inspection. This inspection was carried out over 3 ½ hours on one day and was unannounced. The manager was available to assist with the inspection. Part of the time was spent talking with the manager and looking at records the home keeps on the residents and service users (care plans) and other records the home needs to keep to run its business. Four residents were spoken to at length, and other residents and staff were spoken to during the course of the inspection. What the service does well: What has improved since the last inspection?
The centre is continually striving to improve the service and facilities residents and service users enjoy at the centre. Since the last inspection the rolling programme of redecoration has continued at the centre, maintaining high standards of comfort and cleanliness throughout. The manager is currently working on a new quality audit systems. Ambleside Bank Care Home DS0000005720.V268739.R01.S.doc Version 5.1 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Ambleside Bank Care Home DS0000005720.V268739.R01.S.doc Version 5.1 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS
Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection Ambleside Bank Care Home DS0000005720.V268739.R01.S.doc Version 5.1 Page 8 Choice of Home
The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 3 The admission procedure ensures that all people receive a proper assessment prior to moving in or attending the centre in order to ensure that their care needs have been fully identified and that the centre is capable of meeting those identified needs. EVIDENCE: The admission procedure is sufficiently detailed to guide staff on the actions to be taken to ensure that new residents needs are properly assessed and planned for. Most admissions to the centre for intermediate care are by social worker referral and in consultation with the homes manager who assesses the suitability of the placement. The manager will assess any new residents at a place most suited to the resident either at home or in hospital. There is a clear admission assessment for people who wish to use the centre for short respite breaks. Ambleside Bank Care Home DS0000005720.V268739.R01.S.doc Version 5.1 Page 9 Health and Personal Care
The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 7, 8 and 10 The health and personal care needs of residents and other service users continued to be assessed and addressed appropriately. The health care needs of the residents and service users are well met, with evidence of good multi disciplinary working taking place on a regular basis. Residents and service users could be confident that they would be treated with respect and their right to privacy and dignity would be promoted. EVIDENCE: Three care plans were looked at; one from each of the main services provided to see that full consideration had been for each person’s health, personal and social care needs. The information contained differs depending on the service received. The plans examined had been updated and amended as required. Risk assessments applied to all service users in relation to falls, nutrition and pressure areas. Environmental risk assessments were maintained and updated. Ambleside Bank Care Home DS0000005720.V268739.R01.S.doc Version 5.1 Page 10 Staff have a good awareness of how to protect residents and other service users dignity and privacy. They were seen knocking on bathroom and toilet doors and wait for a response before entering. They were also seen to deal with the individuals in a supportive manner, for example doing things with them and not for them when appropriate. Ambleside Bank Care Home DS0000005720.V268739.R01.S.doc Version 5.1 Page 11 Daily Life and Social Activities
The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 13 and 14 Residents and service users are assisted to maintain contact with family and friends. Residents and service users are kept informed and helped to maintain a good level of independence, and to exercise choice and control over their lives. EVIDENCE: It was clear for observations and from conversations with residents and service users that they are offered real choices about how they live their lives. Residents and service users spoke favourably about the range of activities and entertainment provided. There is access to a good range of reading material in the quiet room in reception. Visitors to the centre are welcome and 2 visitors spoken with were very happy with the care there relative was receiving. They commented on the noted improvement and overall wellbeing of their relative.
Ambleside Bank Care Home DS0000005720.V268739.R01.S.doc Version 5.1 Page 12 One resident who is still very active and fit goes out and about on his own and was, at the time of the inspection arranging his own dental appointment for a visit to the dentist. Residents who live permanently at the home said they had been able to bring in some of their own processions, sufficient to make their bedrooms feel more homely and personal. Ambleside Bank Care Home DS0000005720.V268739.R01.S.doc Version 5.1 Page 13 Complaints and Protection
The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 16 and 18 Residents, service users and their supporters can easily access the complaints procedure. The centre has a robust adult protection policy to ensure that residents and service users are protected from any form of abuse. EVIDENCE: The centre had a written complaints procedure, also a complaints file is maintained. No complaints has been received by the CSCI since the last inspection. Residents and service users spoken with during the inspection made no complaints or described any areas of dissatisfaction with the level of service provision they are in receipt of. Policy and procedures are available for staff guidance in respect of any allegations of abuse and staff are clear about their obligations in protecting residents and service users from abuse in any of its forms. Ambleside Bank Care Home DS0000005720.V268739.R01.S.doc Version 5.1 Page 14 Environment
The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): EVIDENCE: None the above standards were assessed at this inspection. Ambleside Bank Care Home DS0000005720.V268739.R01.S.doc Version 5.1 Page 15 Staffing
The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 29 New staff were subject to an appropriate recruitment process that provides the necessary safeguards to protect residents living at the centre and those service users attending on a daily basis. EVIDENCE: Random inspection of the most recently employed staff members personnel file revealed that these contained an application form, 2 written references, a Criminal Records Bureau check (including a POVA first check), other forms of identification and evidence of induction training. Ambleside Bank Care Home DS0000005720.V268739.R01.S.doc Version 5.1 Page 16 Management and Administration
The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 33 and 35 The centre has sufficient systems in place to review and reassess the standard of provision delivered by the centre. Residents and service users are assured that the centre is run in their best interests. The centre has a satisfactory accounting system in place that protects and safeguards resident’s financial interests. EVIDENCE: There is clear development plan and vision for the centre, which the manager effectively communicates to residents, service users, staff and relatives. The systems for residents/relatives consultation is good with ample evidence that indicates that their opinions have been sought and acted upon. Feedback received in questionnaires issued by the centre is good and opinions are actively sought through residents meetings and day-to-day communication.
Ambleside Bank Care Home DS0000005720.V268739.R01.S.doc Version 5.1 Page 17 The centre administers a number of personal allowances of which an income/ expenditure sheet with a running total is maintained for each resident or intermediate, respite service user. Monies are kept separately and are securely stored. A random inspection of three residents finances was checked against the balance sheet and no discrepancies were noted. Ambleside Bank Care Home DS0000005720.V268739.R01.S.doc Version 5.1 Page 18 SCORING OF OUTCOMES
This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from:
4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable
CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 X X 3 X X X HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 X 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 x 13 3 14 3 15 x COMPLAINTS AND PROTECTION Standard No Score 16 3 17 x 18 3 x x x x x x x x STAFFING Standard No Score 27 x 28 x 29 3 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score x x 3 x 3 x x x Ambleside Bank Care Home DS0000005720.V268739.R01.S.doc Version 5.1 Page 19 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. Refer to Standard Good Practice Recommendations Ambleside Bank Care Home DS0000005720.V268739.R01.S.doc Version 5.1 Page 20 Commission for Social Care Inspection Bolton, Bury, Rochdale and Wigan Office Turton Suite Paragon Business Park Chorley New Road Horwich, Bolton BL6 6HG National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk
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